Upper motor neuron lesions (UMNL), which may be caused by neural disorders such as stroke, cerebrovascular accident, spinal cord injury, cerebral palsy, and/or traumatic brain injury, cause disability and paralysis in millions of people. Since the lower motor neuron system and muscles are generally intact in those with UMNL, muscle contractions may be evoked by directly applying electrical stimulus to the muscles via one or more electrodes. This technique, which may be used for rehabilitation and restoration of motor function, may be referred to as neuromuscular electrical stimulation (NMES). It may also be referred to as functional electrical stimulation (FES) when it is applied to produce a functional outcome, such as standing and/or walking.
A number of challenges have been associated with development of NMES devices and methods, including the nonlinear response of muscle to electrical stimulation, load changes during functional movement, unexpected muscle spasticity, time lag between electrical stimulation and muscle force output, uncertainties in muscle physiology (e.g., temperature, pH, and/or architecture), and muscle fatigue. Improved devices and methods for application of electrical stimulation to a human body to produce functional outcomes would be desirable.